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Clinical presentation and prognostic factors affecting surgical outcomes of secondary macular holes after retinal vein occlusions

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Abstract

Purpose

To describe clinical presentation, morphological features and surgical outcomes of macular hole (MH) secondary to retinal vein occlusion (RVO).

Method

This prospective interventional study evaluated eight eyes with atypical MH (secondary to RVO) and data regarding medical management, pars plana vitrectomy, postoperative anatomical hole closure, visual acuity improvement, morphological features of hole were noted till the last follow-up.

Results

Eight eyes with full-thickness MH in an RVO eye were followed-up for a minimum period of 3 months postoperatively. Five subjects had a RVO episode which occurred more than 6 months before the onset of the recent symptoms (Group 1; 4 branch RVO and 1 central RVO), and 3 subjects had a recent onset branch RVO within 6 months (Group 2). All FTMH cases except one showed closure at the last follow-up. Visual acuity of all eyes improved from 0.91 ± 0.57 logMAR to 0.5 ± 0.3 logMAR (p = 0.093). At baseline, visual acuities of the two groups had no significant difference. Postoperatively, group 1 holes had better visual prognosis, than Group 2 holes, further substantiated by persistence of subretinal fluid in Group 2 eyes till last follow-up. Minimum hole diameter was higher in the recent RVO group, although anatomical closure was obtained in all of these eyes. Most holes had favorable morphological hole features like raised configuration with rounded edges.

Conclusion

In the presence of favorable morphological features, secondary macular holes associated with retinal vein occlusion may show optimal outcomes after surgery. It is not clear whether acutely created holes in recent onset RVO should be operated early. Older holes may have better prognosis.

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Funding

No funds were obtained separately for this study.

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Authors and Affiliations

  1. Department of Vitreo-Retina, Aravind Eye Hospital, Madurai, India

    Chitaranjan Mishra, Naresh Babu Kannan, Sagnik Sen, Kritika Singh, Sourav Damodaran, Piyush Kohli, Karthik Kumar, Renu P. Rajan, Girish Baliga & Kim Ramasamy

Authors
  1. Chitaranjan Mishra
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  2. Naresh Babu Kannan
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  3. Sagnik Sen
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  4. Kritika Singh
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  5. Sourav Damodaran
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  6. Piyush Kohli
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  7. Karthik Kumar
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  8. Renu P. Rajan
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  9. Girish Baliga
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  10. Kim Ramasamy
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Corresponding author

Correspondence to Sagnik Sen.

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None of the author declares that he has any conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards (Aravind Eye Hospital Institutional Research Committee, RET201900210).

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Informed consent was obtained from all individual participants included in the study.

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Mishra, C., Kannan, N.B., Sen, S. et al. Clinical presentation and prognostic factors affecting surgical outcomes of secondary macular holes after retinal vein occlusions. Int Ophthalmol 40, 2817–2825 (2020). https://doi.org/10.1007/s10792-020-01465-7

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  • DOI: https://doi.org/10.1007/s10792-020-01465-7

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